Real people

I've been working on some interesting assignments for medical school recently. We're looking at the histology of different organs in the body, what happens in disease, what are the typical symptoms you will see in a patient, etc. Some of the case studies are challenging, but there is a right answer that we pursue and all the pieces fit together in the end.
I'm learning more and more that this is not so in real life. Over the last week as I've worked in the hospital and in the doctor's office I've seen all sorts of patients, and not one single one of them was like my assignment case studies. Take for example Mr. Buttercup (name changed of course!) from work today. Poor Mr. Buttercup is a palliative patient, meaning he is dying slowly, and it seems like every system in his body is failing. I went into his room to change a dressing on a wound on his heel and I had to wake him up as he was nearly comatose. The sore on his heel is a pressure sore, caused by constant pressure on that one spot as he lies in bed all the time. The flesh had turned black and necrotic.
With ulcers of this type there isn't usually a lot of pain, even though they look horrendous, because the tissue is well and truly dead. I wasn't expecting Mr. Buttercup to cry out in pain when I unwrapped the bandage, but he did.
"I'm so sorry." I kept saying to him.
The ulcer was necrotic and had yellowish drainage coming out of it. I felt around the perimeter of it and the skin was hot and swollen, which is unusual for that kind of ulcer. It was probably infected. I cleaned and dressed it and tried to make him comfortable before leaving.
I sat down later with the doctor and discussed the patient. He had pressure ulcers, but they were infected. He wasn't drinking a lot of fluids so he was dehydrated. He couldn't swallow properly so he wasn't able to take his medications very well. He wasn't moving much so his circulation was poor. The doctor ordered a medicated cream for the wound and I called the occupational therapist to order a special mattress. We talked on the phone for a while and discussed different options.
"Honestly," she said to me, "I don't think it will make much of a difference."
"Well, what's being done now is not helping at all." I said.
"Perhaps we can try it then." She agreed. "There's nothing to lose with trying."
The sad reality of nursing dying people is that there is no hope of recovery. But I would like to see Mr. Buttercup pain free, if I can, and comfortable.
He's not a textbook patient or one like my assignment case studies. He's a real person, and when I'm having to clean his wound and he is wincing and when I leave and he thanks me with such a gentle smile, I feel tears in my eyes. I know I get too emotionally involved sometimes, but he is a real person after all. I have no connection to the fascinating cases I'm writing about on paper. They are 2-dimensional people with organized symptoms and signs that fit together like puzzle pieces with a diagnosis that I can say "aha! that's it!" to.
Mr. Buttercup is a real person, like me, and we share humanity and we share smiles and a handclasp and an intimate connection as I help him die gracefully, knowing that someday I'll be in his shoes.